New developments in medical imaging: The potential and clinical applications in otolaryngology and head and neck disease

Medical imaging techniques have been evolving rapidly. Both acquisition and
reconstruction of data are far less time-consuming, MRI units as high as 7 Tesla are
in clinical use and new techniques, for example diffusion weighted MRI, are becoming
standard of care for varying clinical indications. In this thesis, I evaluated its potential
and clinical applications in otolaryngology and head and neck disease.
Imaging is used both in diagnostics and follow-up. Diffusion weighted MRI has a place
in daily practice for the diagnosis of middle ear cholesteatoma in selected primary
cases and in postoperative cases, in some of which a second look operation can be
avoided. For middle and inner ear pathology, the use of 7 Tesla MRI does not have a
benefit yet in comparison with the 1.5 and 3 Tesla. This also applies for small laryngeal
carcinoma, in which 7 Tesla is not feasible yet and 3 Tesla MRI is not yet superior to
CT. However we do see clinical potential in 3 Tesla MRI for small laryngeal carcinoma
with further technical development of this technique.
FDG-PET/CT in primary head and neck cancer is complementary to routine diagnostics,
also for staging of the neck. In case of pathological lymph nodes on PET and/or CT scan,
in most cases a high nodal target volume is given.